Keeping Kids With Diabetes Safe At School

Diabetic Children and School

School children with type 1 diabetes can be safely cared for at school by a mix of medical and non- medical staff.

A separate study in the same issue finds a new therapeutic approach to weight loss helps women with diabetes shed extra pounds and keep them off, when added to other lifestyle interventions.

Helping children with type 1 diabetes manage their disease during the school day can be done safely and effectively by non-medical personnel, a study in Virginia schools has shown. The study followed legislation passed in 1999 that required Virginia schools to train at least two instructional, administrative or other employees how to administer insulin and glucagon.

Surveys conducted among the parents of Central Virginia school children in the wake of this new law found that blood glucose monitoring, insulin administration and the treatment of low blood glucose episodes could be safely handled by a variety of school personnel, as well as school nurses.

"Children with diabetes spend up to half their waking hours under the supervision of the school system," said lead researcher Dr. William L. Clarke, of the University of Virginia Department of Pediatrics. "Knowing that their diabetes can be managed safely by a variety of trained adults can be reassuring to parents, care providers, and school administrators. The Virginia legislation is a model for how non-medical personnel can be used when school nurses are unavailable."

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The study findings strengthen the American Diabetes Association's ongoing efforts to ensure the safety and quality of care and education for all students with diabetes, through its "Safe at School" campaign.

Motivational Interviewing (MI), a therapeutic approach that helps people reflect upon why they want to change their lives, can help women with diabetes lose weight -- and keep it off -- when added to other lifestyle interventions, according to new research.

The 18-month, randomized, controlled study, by researchers at the University of Arkansas for Medical Sciences and Ohio Wesleyan University, found that women who received Motivational Interviewing (MI) in addition to group-based cognitive behavioral therapy lost more weight (and kept it off longer) than women who received only the group treatment. On average, the women who received both therapies lost three more pounds after six months; the difference increased to four pounds by 18 months.

Motivational Interviewing is a therapeutic approach that helps people reflect upon why they want to change their lives, rather than what might stand in the way of their doing so. It differs from cognitive behavioral therapy in that it does not initially emphasize problem solving, but instead helps people expand upon their reasons for wanting to change. The study looked at what happened when women were given just cognitive behavioral therapy (in a group setting), compared to both the group cognitive therapy plus individual MI sessions. Those who received both types of therapy lost more weight, kept it off longer and did a better job of lowering blood glucose levels, the study found.

"The study shows MI helped the women stay engaged in the behavioral program," said lead researcher Delia Smith West, PhD. "It helped them stay on track with diet and exercise. By adding this reflection and amplification of their reasons to change, they participated in the program more fully and were able to use the resources available to them to a greater extent."

The study found the addition of MI worked better for longer with white women than it did for African American women, who were not able to sustain the benefits of treatment over time. Further research needs to be done to find better ways to reach this demographic, which is disproportionately affected by type 2 diabetes.

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